title: Terlipressin in hepatorenal syndrome.
abstract: OBJECTIVE
  To compare the pharmacology, dosing, and adverse reactions of vasopressin and terlipressin for the treatment of hepatorenal syndrome (HRS) and assess the efficacy of the investigational drug terlipressin for HRS.
  
  
  METHODS
  Articles evaluating prospective studies for vasopressin and terlipressin were discussed after being identified through PubMed (1966-November 2010), International Pharmaceutical Abstracts (1970-November 2010), and EMBASE (1985-November 2010) with combinations of the following terms: vasopressin, terlipressin, and hepatorenal syndrome. In addition, reference citations from publications identified were reviewed. Thirteen studies were identified for terlipressin, along with 4 meta-analyses and 1 case report. For vasopressin, 2 studies were identified.
  
  
  METHODS
  Prospective clinical studies directly comparing terlipressin and vasopressin were evaluated, as well as prospective clinical studies and meta-analyses for terlipressin in HRS.
  
  
  RESULTS
  No randomized, placebo-controlled trials using vasopressin for the treatment of type I HRS have been published, and 4 randomized studies involving 197 patients provide the most current outcome data for use of terlipressin in HRS. Terlipressin differs significantly from vasopressin with regard to its pharmacology, dosing, and adverse drug reaction profile. There is a paucity of data on vasopressin for HRS.
  
  
  CONCLUSIONS
  No definitive recommendations can be made for the use of terlipressin for this indication until further, well-conducted studies are performed.
authors.affiliation: Medical Intensive Care Unit, Department of Pharmacy Services, Medical University of South Carolina, Charleston, SC, USA. mazurj@musc.edu
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Mazur
authors.forename: Tanna B
authors.initials: TB
authors.lastname: Cooper
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Dasta
mesh_terms: D001127:Arginine Vasopressin / Q000009:adverse effects / Q000627:therapeutic use*; D006530:Hepatorenal Syndrome / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008236:Lypressin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000077585:Terlipressin; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D014662:Vasoconstrictor Agents; D001127:Arginine Vasopressin; D008236:Lypressin; D000077585:Terlipressin